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Risk factors for urinary incontinence
Urinary incontinence usually develops not from one cause but from a combination of factors. Knowing your risks helps you start prevention in time, pay attention to the first symptoms and tell your doctor what really matters.
What the study in Kazakhstan found
In 2025, a multicentre case–control study involving 2,061 women was carried out in healthcare facilities across Kazakhstan. The researchers compared women with and without urinary incontinence to find out which factors were linked to the condition independently of age and other causes.
The figures are odds ratios: how many times higher the odds of incontinence are when the factor is present compared with when it isn't. Studies like this show associations but don't prove that the factor itself causes incontinence. More about the study.
The authors' main conclusion: urinary incontinence in women in Kazakhstan is linked mainly to obstetric and metabolic factors — which means a lot can be done through weight management, care during pregnancy and after birth, and early pelvic floor assessment.
Pregnancy and childbirth
During pregnancy the growing uterus presses on the bladder, and hormones make ligaments more elastic. During a vaginal birth, the muscles, nerves and connective tissue of the pelvic floor are stretched a great deal. The risk is higher if:
- it was a multiple birth (twins, triplets);
- the baby was large (usually 4 kg or more);
- pushing was prolonged, or forceps or vacuum were used;
- you've had several births;
- leakage started during pregnancy.
A caesarean section reduces strain on the pelvic floor during birth but doesn't remove the risk entirely: pregnancy itself matters too. What to do is covered in Pregnancy, birth and the pelvic floor.
Excess weight
Every extra kilogram increases pressure on the bladder and pelvic floor. This is one of the strongest risk factors — and one you can change: losing weight reduces leakage.
Age and menopause
With age, muscles lose strength and the bladder becomes less elastic; after menopause, lower oestrogen thins the tissues of the urethra and vagina. But incontinence isn't an inevitable part of ageing: it can be treated at any age.
Other factors
Can be changed
- excess weight;
- constipation and straining;
- smoking and chronic cough;
- lifting heavy loads while holding your breath;
- a lot of caffeine, fizzy drinks, alcohol;
- too little or too much fluid;
- an inactive lifestyle.
Need to be taken into account
- pregnancies and births;
- age and menopause;
- pelvic surgery, including hysterectomy;
- diabetes;
- neurological conditions (stroke, multiple sclerosis, Parkinson's disease, spinal injury);
- some medicines, such as diuretics;
- incontinence in your mother or sister.
What to do if you have risk factors
- Start with what you can change: weight, constipation, fluid intake, cough.
- Learn pelvic floor muscle training — the most effective prevention.
- Tell your doctor about your risk factors — especially during pregnancy, after birth and around menopause.
- At the first signs of leakage, don't wait: take the ICIQ-SF test and see a doctor.
Sources
- Ryspayeva Zh, Khismetova Z, Serikova-Esengeldina D, et al. Risk Factors and Quality of Life in Women with Urinary Incontinence in Kazakhstan: A Multicenter Case–Control Study. IJERPH. 2026;23(7):893. mdpi.com
- EAU Guidelines on Non-neurogenic Female LUTS. uroweb.org
- NICE guideline NG123. 2019. nice.org.uk